Perioperative management of adult and pediatric sleep apnoea

Amongst the various diseases required to be screened preoperatively obstructive sleep apnoea (OSA) is one of the most underdiagnosed conditions. The various screening tools devised to prevent OSA related postoperative complications are: Berlin questionnaire, STOP-BANG questionnaire, American Society of Anesthesiologist checklist and Perioperative Sleep Apnea Prediction Score. Among these, the STOP –BANG questionnaire is validated, sensitive, specific and viable and can even be self administered. Portable sleep study is the most practicable approach to confirm the diagnosis preoperatively in suspected cases. Continuous positive airway pressure (CPAP) administration is recommended for reducing the risk of complications related to OSA during post and or pre operative period although; the data describing the impact of CPAP therapy on adverse outcomes are limited. Also, close monitoring of patients postoperatively; avoiding use of sedatives and awake extubation are important components of postoperative care. Using CPAP in pre and or postoperative period can not only reduce the postoperative complication but also diagnose and sensitize the patients towards the long term management of OSA. The perioperative management of pediatric OSA is also similar to adult OSA, though clinically both are different.